NPIMap

Organization Active NPI

Pratt Medical Group, Inc

Doing business as Pratt Medical Group, Inc-Quincy/Hyde Park Associates

  • Internal Medicine Physician
  • Quincy, MA
National Provider Identifier
1447525241
Registry record updated Apr 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PRATT MEDICAL GROUP, INC
Doing business as
Pratt Medical Group, Inc-Quincy/Hyde Park Associates
Practice address
1690 Crown Colony Dr
Suite 209
Quincy, MA 02169-0913
Phone
(617) 364-4380
NPI assigned
Mar 13, 2012
Last updated
Apr 21, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Edward Gallegos
Title
Director
Phone
(617) 636-7549

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

1690 Crown Colony Dr
Suite 209
Quincy, MA 02169-0913

Mailing address

800 Washington St
Box 1013
Boston, MA 02111-1552
Phone (617) 636-5000

Other names 1

  • Pratt Medical Group, Inc-Quincy/Hyde Park Associates Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040807000255 MA Part B Supplier - Clinic/Group Practice 3375515661 Receives reassigned benefits from 393 practitioners
13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lowell, MA; Medford, MA; Melrose, MA; Norfolk, MA; Saugus, MA; Somerville, MA; Stoneham, MA; Weymouth, MA…

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

National Provider Directory

National Provider Directory

Locations

1690 Crown Colony Dr
Ste 209
Quincy, MA 02169
Phone (617) 364-4380

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492732800000",
    "number": "1447525241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "address_2": "BOX 1013",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1690 CROWN COLONY DR",
            "address_2": "SUITE 209",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021690913",
            "telephone_number": "617-364-4380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRATT MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-13",
        "last_updated": "2017-04-21",
        "status": "A",
        "authorized_official_last_name": "GALLEGOS",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "617-636-7549"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pratt Medical Group, Inc-Quincy/Hyde Park Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Quincy, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.